The medical research world has been concerned about the problem of ghostwriting for more than a decade. Over the past year, the issue has been repeatedly raised in the mainstream media, with U.S. Senator Chuck Grassley seizing upon the issue, and the New York Times working to bring pharmaceutical company documents into public view. Most of the commentary has focused on the ethics of academics serving as authors on papers they did not write and on some of the most egregious actions by pharmaceutical companies.

These efforts miss the ways in which Big Pharma has developed new forms of medical research to serve its own interests. It is important to understand the real meaning of ghostwriting campaigns and the ghost management of medical research in general.